The Enhanced Doctor-Chapter 420 Super Bacteria

(Thank you to my friends zHL, novel reader 150916120606029, and Pirate Flag Xino for their ticket support)

Post-operative infections are actually quite common when treating many patients. However, a case like this patient’s, flaring up so quickly and unusually, is quite rare.

This is because the most common type is a surgical site infection, which manifests on the wound. Signs include redness, swelling, heat, pain, and exudate, mostly caused by Staphylococcus and Streptococcus bacteria.

This patient’s wound was very clean, yet the infection flared up remarkably quickly.

After all, bacterial replication takes time. The patient had just been wheeled into the ward; I’m afraid Su Wenhao hadn’t even had time to explain the necessary precautions.

"President Liu, what do you think is the situation?" Wang Chao asked after a pause.

"I can’t be sure. It might be that the patient had other conditions we hadn’t detected," Liu Banxia replied with a frown.

"Otherwise, a normal post-operative infection shouldn’t flare up this quickly. It was possible the appendicitis had obscured other underlying conditions."

Wang Chao glanced at the patient, who was now only partially conscious and unable to be questioned.

Liu Banxia carefully recalled the details of his initial consultation with the patient, needing to find clues in their conversation.

The patient was admitted to the emergency room after fainting, with clear symptoms of acute abdominal pain. McBurney’s point also showed clear rebound tenderness, and the blood test results were consistent with acute appendicitis.

The diagnosis of appendicitis was sound. So, this patient was somewhat unlucky... Unlucky?

Thinking of this, Liu Banxia’s eyes lit up.

"Everyone, listen up," Liu Banxia said.

"All of you who have just been in contact with the patient, do not touch your mouth or nose, and disinfect your hands. The patient’s bedsheets need to be sealed and stored separately. The other two patients in this ward must be moved to different beds." 𝑓𝑟ℯ𝘦𝓌𝘦𝘣𝑛𝑜𝓋𝑒𝓁.𝑐ℴ𝓂

"Take samples of these stains on the patient’s bedsheets for a latex agglutination test. I suspect the patient is infected with Clostridium difficile. Once the test results are back, administer oral Vancomycin, provide immunomodulatory therapy, and give probiotics. Also, repeat the colonoscopy."

Even the busy nurses in the ward were taken aback by his words.

"The patient has taken multiple antibiotics over the past fortnight and has experienced diarrhea and a sharp drop in blood pressure, all consistent with a Clostridium difficile infection," Liu Banxia explained.

Even these nurses knew how aggressive Clostridium difficile was, as it’s a superbug that often causes hospital outbreaks.

The ’difficile’ in its name isn’t for show; this bacterium is exceptionally drug-resistant. Currently, only Vancomycin and Metronidazole have even a slight effect.

And even these two drugs are only marginally effective.

"Su Wenhao, have you contacted the patient’s family?" Liu Banxia looked at Su Wenhao again.

Su Wenhao nodded. "He isn’t married; his parents are on their way."

"Notify me when they arrive. I’ll explain," Liu Banxia said.

This bacterium was too special, too complex, and too aggressive. He was worried Su Wenhao would struggle to manage the family’s emotions because there was a high probability of losing the patient to this disease.

Everyone sprang into action again. During routine nursing care in a general ward, staff wouldn’t typically wear gloves, yet Clostridium difficile is transmitted via the fecal-oral route.

From that point on, all of this patient’s excretions had to be sealed and transported separately. This protocol had to be followed even before a confirmed diagnosis.

He had been downstairs for less than five minutes when the patient’s parents arrived.

"I am your son’s attending physician," Liu Banxia said. "His current condition is rather complex."

"The appendectomy was successful. However, he may now have contracted Clostridium difficile. We are still waiting for the final test results. If confirmed, we will begin the appropriate treatment."

"When you visit him later, you will also need to wear masks and gloves. This bacterium is contagious, so special precautions are necessary."

"Doctor, is it serious?" the patient’s father asked.

Liu Banxia hesitated slightly, then nodded. "If it is confirmed, the situation will be very serious. Have either of you had diarrhea recently?"

The patient’s parents shook their heads.

"That’s a relief. If the infection is confirmed, we’ll also need to contact his workplace," Liu Banxia said.

"This Clostridium difficile is extremely drug-resistant. External infection occurs primarily through fecal-oral transmission. Internal onset is typically due to the ingestion of large quantities of antibiotics."

"This bacterium is a normal component of human gut flora. However, excessive antibiotic use can kill off many other gut bacteria, allowing Clostridium difficile to multiply and eventually cause an outbreak."

"Not only is this bacterium difficult to treat, but because it’s a normal gut inhabitant, there’s a high risk of recurrence even after recovery."

"Each recurrence exacerbates the condition and makes treatment more difficult. If it’s confirmed, I will contact our Director of Internal Medicine and ask him to consult on the case."

Although the test results weren’t back yet, and the system hadn’t registered the task as complete, Liu Banxia was already quite certain it was Clostridium difficile.

All the symptoms matched; it wasn’t pseudomembranous colitis.

To be precise, the Clostridium difficile infection had already begun to develop in the patient upon admission. The surgery then provided an opportunity for the bacteria to proliferate, which is why the symptoms manifested so rapidly post-operation.

It’s better to tell the elderly couple all the bad news at once, rather than delivering it piecemeal.

"Doctor, can this be cured?" the patient’s father asked again.

"Theoretically, recovery is possible by rebalancing the body’s systems, but each patient’s situation is unique," Liu Banxia replied.

"Once the results are in, we’ll perform a colonoscopy to assess for any intestinal damage. Clostridium difficile produces enterotoxins that cause massive fluid loss and tissue necrosis in the intestines."

"It also produces a cytotoxin that causes localized cell death in the intestinal wall, directly damaging it. Currently, we need to assess the patient’s condition before determining the next steps for treatment."

"Doctor, can you tell me his chances of being cured?" This was the patient’s father’s third question.

Liu Banxia paused. He could see the patient’s parents were very emotional, yet they were still managing to keep their feelings under control.

"I can’t give you a precise answer at the moment, but I can assure you that our hospital will do its utmost," Liu Banxia replied.

"Thank you. We’re in your hands," the patient’s mother said, tears flowing freely.

Liu Banxia sighed inwardly. Their thanks weigh heavily, especially since I have no guarantees right now.

A nurse was assigned to help the patient’s parents with protective gear before they were led to the ward.

"President Liu, it’s confirmed. It is indeed Clostridium difficile," Wang Chao reported, running back with a solemn expression.

DING! Task: Postoperative Recovery from Sudden Infection - Completed.

Reward: 300 Experience Points, 500 Diagnostic Skill Proficiency Points, 2 Glory Points.

Mission Rating: Flawless. Bonus Reward: 500 Experience Points, 500 Diagnostic Skill Proficiency Points, 5 Glory Points.

Congratulations! Host Level increased to 50 (132,895/138,900 EXP). Reward: 1 Attribute Point, 5 Glory Points.

Host has reached Level 50. New items added to System Store. Please check at your convenience.

"President Liu, what should we do next? Just perform a colonoscopy?" Wang Chao pressed.

"You go ahead with the colonoscopy. I’ll go find Director Xiao to discuss this. This is the first time I’ve encountered a patient like this," Liu Banxia replied.

I really have no other choice. Standard textbook procedures are unlikely to be enough for this patient.

"Well, well, what brings a busy man like you here?" Director Xiao teased as Liu Banxia entered.

"Director Xiao, I need your help," Liu Banxia said. "We’ve admitted a patient with Clostridium difficile. We’ve started oral Vancomycin and are performing a colonoscopy."

Upon hearing this, the jovial expression on Director Xiao’s face vanished. "There’s not much to be done beyond hydration, adjusting protein levels, boosting immunity, and regulating intestinal flora."

"Next is to check for intestinal perforation. You’re doing a colonoscopy, so you’re already considering this. These are all tasks for you surgeons. By the way, you’ve taken precautions against transmission, right?"

Liu Banxia nodded. "Already done. We’ve also contacted his company via the emergency responders; their people will come for testing shortly."

"Based on current findings, the Clostridium difficile likely started proliferating before he was even admitted. That’s why he developed a high fever and hypotension so quickly after surgery, right after being moved to the ward."

"That’s the most difficult part," Director Xiao said. "If it has already caused significant intestinal damage, a colostomy might be the only option, right?"

Liu Banxia nodded again. "Dehydration and some bleeding points wouldn’t be the worst of it. It’s necrosis we’re worried about. Just thinking about it gives me a headache. This is all because he took large amounts of antibiotics over the last fortnight."

"The government has been trying to educate the public about this, but not many people pay attention," Director Xiao said.

"It might also be related to our habits. If you have a headache or a slight fever, you just find some medicine at home and try to push through it."

"Director Xiao, I should get back. I need to wait for the colonoscopy results. The patient’s parents are very composed, but that almost makes it harder for me," Liu Banxia said.

"Alright, go on. Call me directly if you need a consultation," Director Xiao nodded.

Liu Banxia coming personally to discuss the case, rather than just calling for a consultation, showed respect. He thought highly of Liu Banxia and was happy to accommodate him.

Walking back, Liu Banxia’s headache flared. He likely first developed this during that bout of so-called ’gastrointestinal flu’; this must be a relapse.

And as he’d told the parents, each relapse further diminishes the chances of a cure.